An Integrated Medicine Weight-Management Clinic

By Bruce H. Robinson, MD, FACS, MSOM (Hon)

AIMC Berkeley is creating a fully integrated weight management clinic, one which should be unique. There are very few clinics that specialize in weight management using a fully integrative approach, and no other clinics I am aware of utilize the special healing and balancing effects of combining Japanese and Chinese medicine therapy with appropriate medical treatment for each client's individualized condition.

This multimodal, integrated medicine approach will allow our clinic to treat obesity successfully without resorting to stimulant diet pills or surgery. Our clients will not only lose weight, they will learn healthy, life-long skills to help keep it off.

The greatest health crisis facing America is the recent explosive increase in the prevalence of obesity and diabetes. It is frightening but true that there are twice as many obese people today as there were 10 years ago. One-third of all Americans are now obese, and another third are overweight. This poses a great health risk, particularly because obesity is so closely related to the onset of diabetes mellitus. A report by the Centers for Disease Control was released (American Journal of Preventive Medicine, May 2006) that indicated the incidence of type 2 diabetes increased dramatically in the past six years up until 2003 (most recent figures available). According to the CDC study:

Among U.S. adults aged 18-79 years, the incidence of diagnosed diabetes increased 41% from 1997 to 2003. During this period of rapid change, incidence increased at a greater rate among obese people, resulting in obesity being more prevalent among incident cases at the end of the time period than at the beginning, said the researchers. Altogether, this data suggests that obesity is a large factor in the increasing incidence of diagnosed diabetes. Lifestyle interventions that reduce or prevent the prevalence of obesity among persons at risk for diabetes are needed to halt the increasing incidence of this disease.

There is another serious concern lurking behind the problem with weight gain. A high-fat and high-carbohydrate diet, when coupled with inactivity, often leads to insulin resistance, leading to more fat in the body, plus high blood pressure and pre-diabetes or actual diabetes. This increasingly common condition is known as syndrome X. These elevated levels of insulin create a high-risk health problem and the resultant extra fat is especially hard to get rid of, requiring dedicated efforts. A high percentage of overweight or obese individuals suffer from syndrome X and many do not know it.

Our nation's high level of physical inactivity, the availability of high-carbo-hydrate and high-fat junk food and excessively large servings in restaurants all contribute to the tendency to put on excess weight. Yet no one really wants to be fat. As a result, millions of Americans are turning to weight-management clinics, which often feature weight control based on diet pills, which are stimulants with significant side effects (anxiety, dry mouth, palpitations, insomnia, irritability and other symptoms). Many other overweight individuals are resorting to operative procedures such as liposuction, gastric stapling, laparoscopic banding and intestinal bypass surgery. These operations are expensive. One of the least invasive of these is laparoscopic gastric banding, which still costs between $10,000 and $15,000 and requires drastic lifestyle changes. The other operations noted above can cost far more. These procedures are painful to go through and they have a significant incidence of operative and post-operative complications. A better solution is clearly needed.

AIMC Berkeley's integrated medicine weight management clinic will eliminate the need for diet pills or surgery, yet will achieve weight reduction in a similar or even enhanced fashion. Combining a careful Western medical evaluation and an Oriental medical evaluation with an integrated treatment plan, our patrons will lose their excess weight while adopting a healthy dietary intake. We will provide an ongoing supportive program to help them keep off the excess weight and maximize their overall physical, mental and spiritual health. Regaining the weight is one of the major drawbacks of other weight-reduction programs, as they usually do not deal adequately with the combination of problems that caused the excess weight gain in the first place.

The clinic will feature Japanese and Chinese acupuncture, Kampo and Chinese herbal treatments known to combat obesity. In addition, individuals will have the supportive backup of individualized diet instruction, medical qigong, exercise guidance and cognitive qigong, exercise guidance and cognitive therapy classes to deal with dietary addiction issues. Our mind-body professionals also will offer our patrons such specialized therapeutic modalities as guided imagery, hypnotherapy and stress-management counseling.

The clinic initially will be conducted in the current clinic facilities at the AIMC, Berkeley Campus in Berkeley, Calif. We anticipate relocating the clinic to an offsite facility, as growth requires. This clinic is separate from our college, but will be closely affiliated with it. AIMC Berkeley students will be participating in the treatment of clients and will be able to witness truly integrated medicine in action.

What motivates overweight individuals who are on a self-damaging health path to change their lives for the better? The first motivation is a deepening unhappiness about their overweight or frankly obese condition, which becomes a progressively strong-er pull to turn things around. Perhaps on top of their weight frustrations, they may have recently been diagnosed with a related medical problem such as impending diabetes, actual diabetes, high blood pressure, heart disease, or gallbladder disease with gallstones (one of the most common health problems in America).

One of the most effective ways to capture these individuals' motivation to overcome their health problems is to provide services that offer the hope of a way out. Trying to find some workable solution, millions of overweight Americans are signing up for weight-control programs that include pre-packaged food, meal-replacement products, food supplements and exercise programs. Many programs in the country today are based on the use of diet pills or surgery.

Our multimodal approach will have a powerful appeal. In addition, we will be drawing the overweight person into a community of supportive, like-minded individuals who know the way to find something better. Equipped with correct information for an improved lifestyle and shown the way to accomplish these tasks, one person inspires the next and the whole process nurtures and supports itself in an upward spiral of healing energy.

Obesity is now considered a disease. No one who is overweight should be stigmatized. Like other health problems, obesity will respond to proper treatment and a positive attitude. Our medical specialists in weight-management medicine point out there are several different conditions that are noted in obese patients. These include:

those who have no metabolic abnormalities and are simply overweight;

those with elevated insulin and normal blood glucose levels;

those with elevated insulin and elevated glucose in the pre-diabetic range;

those who have syndrome X (they need specific aggressive treatment);

those with clinical diabetes; and

those with hypothyroidism, low adrenal function or other metabolic abnormalities.

These physicians will prescribe appropriate medications when indicated, such as Glucophage (metformin) and chromate for those who are insulin-resistant (when the insulin cannot transport glucose into the cells as it should). In cases where the patient is hypothyroid (a very common condition in middle-aged people), the excessive weight gain may be intensified by the low thyroid condition. In such cases, Synthroid (levothyroxine) or Armour thyroid hormone may be prescribed.

The Oriental medical practitioner may identify one of at least 10 patterns of imbalance that can lead to weight gain, such as stomach heat and damp blockage, phlegm dampness brewing internally, or spleen qi vacuity weakness, along with many other such patterns. The practitioner will perform appropriate acupuncture and prescribe the proper herbs to correct the patient's individually manifesting disease mechanisms. An appropriate diet also will be given to the patient, along with instructions for eating food at the appropriate temperature for that individual's medical condition. Classes will be held regularly on nutrition and dietetics. These will be offered as a free service to the community.

As a retired medical doctor with more than 30 years of medical practice, I am dedicated to the goal of bringing together in close partnership the synergistic effectiveness of Western medicine and Oriental medicine.

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